The terrible wait meets the eternal debate

Date: May 17 2013

There is nothing simple about the funding of hospitals in this state, and arguments about who bears primary responsibility for their situation are threaded with distracting political invective. Around it goes, in circles, with no answers offered.

Try explaining to the old and infirm, young children and the disadvantaged why they must wait years for elective surgery. Try explaining why the pain they endure and the uncertainty that plagues their daily lives are prolonged by politicians who don't do what they promised. Victoria's Health Minister, David Davis, cannot be allowed to buckpass the problems besetting this state's hospitals to the federal government alone. This is his backyard, and the Coalition promised before the 2010 state election that it would ''slash waiting lists''.

To that end, it is simply offensive when Mr Davis resorts to political point-scoring whenever he is forced to confront the reality of the state's hospitals. On Tuesday, for example, Mr Davis took the cover of federal budget day to quietly release a report by a three-person panel which examined the data for waiting lists back in 2011. That report was handed to the government nine months ago. Why the long wait, you might ask, especially as much of it is a specialised discussion about categorising certain medical treatments and the methods of collating appropriate data on how long patients wait from first consultation to eventual treatment. But, never one to miss an opportunity, Mr Davis infected it with political rhetoric, saying it offered a ''clear stocktake on Labor's performance in outpatients''.

Well, it's 2½ years since your government came to power, Mr Davis, and each month we get a clearer picture of how the Coalition's administration stacks up. At March 31, 50,565 people were waiting for surgery that medical specialists deem may not be urgent but still needs to be done. That is 10.4 per cent more than a year ago, and well above the 40,000 the Coalition highlighted when it came to power. The waiting list for elective surgery at the Royal Melbourne Hospital rose 19 per cent year on year; it was up 11 per cent at the Royal Children's Hospital; and there have been big increases too at the Royal Women's Hospital, the Western Hospital in Footscray and Sunshine Hospital.

Changes in quarterly figures may be influenced by all sorts of issues, not just funding constraints. Still, the lists are not coming down and that is unacceptable for a state that prides itself on being the home for many of the world's leaders in medical technology, research and surgical techniques.

Hospitals funding is simply inadequate. Without real increases in funding, as opposed to the cutbacks the hospitals have endured, this state's health system will deteriorate. Our population is ageing, and that means each year more people will need medical services to keep them alive, manage complex health conditions or alleviate chronic pain. Neither the Gillard nor the Napthine government seems to grasp this. The inexorable demands on hospitals, coupled with the rising costs of medical treatment, demand a higher level of immediate funding, and commitments from federal and state governments to real increases in future years.

Smaller house, greater sense

It has always been a dilemma for Australia's elderly home-owners - those who are unable to move to a smaller home without reducing or losing their age pension. This has meant some seniors have had little alternative but to stay on in their family home despite difficulties in affording upkeep or maintenance costs.

Happily, this impasse has been recognised. This week's federal budget contains $112.4 million for a pilot scheme designed to help to downsize their homes without reducing their age pensions. From July 1, 2014, seniors who have owned their home for at least 25 years, and decide to sell, will have up to $200,000 of the proceeds exempted from Centrelink means testing. Any money invested and interest earned will be exempt for 10 years.

Encouraging people to downsize, instead of deterring them, makes eminent sense for practical, social and economic reasons. Older people would often cope better in a smaller property, and larger properties could then be made available to younger buyers with growing families. In addition, as Curtin University housing economist Rachel Ong says, the scheme will enable people to save any equity from downsizing rather than having to use it immediately. This scheme is a trial. It, or something like it, should be implemented permanently.

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